More boys go under knife as parents opt for kind cut

By DANIELLE TEUTSCH

CIRCUMCISION is making a comeback as a new generation of parents arm themselves with medical research to justify their decision.

The rate of circumcision for baby boys in NSW rose from 13 per cent in 1999 to 18 per cent last year, according to Medicare figures.

It's a long way from the 1950s when boys were routinely circumcised but Sydney paediatric surgeon Dr Anthony Dilley predicts the rate will keep rising. This is despite NSW Health banning circumcisions from public hospitals in 2006, except in cases of medical emergency.

"By the time today's baby boys are in kindergarten, it will be 30 per cent," Dr Dilley said.

Dr Dilley said parents were asking for circumcision because they thought it would benefit their child – "to look like dad", be more hygienic and reduce risk of disease – rather than for cultural or religious reasons."My own gut feeling is that there are parents who didn't get it done 20 or 30 years ago because they were bullied out of it," Dr Dilley said. "Most parents now don't stand for being told: 'Don't do it.' They will do their own research."

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Proponents of circumcision such as Professor Brian Morris from the University of Sydney school of medical sciences say it is a kind of "surgical vaccine", pointing to studies showing it reduces the incidence of urinary tract infections, sexually transmitted diseases, penile cancer and penile inflammatory disorders, as well as being more hygienic.

It has also been shown to reduce the incidence of cervical cancer in female partners.

"At birth it's a very simple, safe procedure that gives immediate benefit through infancy and continues through life," he said.

The Royal Australian College of Physicians recently softened its opposition towards circumcision. Its 2004 position statement said there was no medical indication for routine neonatal circumcision and that benefits needed to be weighed against a complication rate of 1 to 5 per cent but its interim statement released last year was more nuanced, saying parental choice should be respected.

The college's paediatric and child health policy committee chairman Professor David Forbes said: "We have stepped back and said: 'Yes, there are ethical issues around circumcision but ultimately we have to have a policy that fits with society's practice and acknowledging parents' role in the decision-making process, while recognising the potential benefits and risks'."

But the statement recommends parents should wait until their boys are old enough to make their own decision on circumcision – the subject of a petition by pro-circumcision clinicians led by Professor Morris, who say infancy is best for the procedure.

Royal Australian College of General Practitioners national spokesman Dr Ronald McCoy said he didn't believe there was any reason to circumcise except for a handful of medical indications but agreed the debate was not going away.

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"It certainly is a real issue. Parents want to find out what's best for their kids," Dr McCoy said.

General Practice NSW chairman Dr Ken Mackey said circumcision was generally safe but there were still slight risks of infection or deformity of the penis. "As always, fully informed consent is important," he said.